Methodological challenges and recommendations for acupuncture clinical study: A scoping review

Background

Methodological issues and challenges hinder the high-quality development of acupuncture clinical studies.

Objective

To systematically summarize the methodological issues, challenges, and recommendations in acupuncture clinical research using the participant, intervention, comparison, outcome, and study design (PICOS) framework to generate a comprehensive list of methodological questions and recommendations.

Methods

We searched seven databases for articles on the methodological aspects of clinical acupuncture research from their inception to March 24, 2023. Two researchers independently screened the titles, abstracts, and full text of each article. Data extraction and analyses were performed for the eligible studies. Finally, the methodological challenges and recommendations for acupuncture clinical studies are listed, and the frequency of methodological challenges is displayed in a sunburst chart.

Results

A total of 226 studies were included in the review, most of which originated in China (173, 77 %), followed by the United States (25, 11 %) and the United Kingdom (12, 5 %). Clinical research on acupuncture faces methodological challenges that span the five elements of the PICOS framework. The most frequently mentioned issues were related to comparison, followed by study design and interventions. If further categorized, the establishment of the control group is undoubtedly the most concerning issue for researchers.

Conclusion

This review provides a comprehensive overview of the challenges and recommendations for each aspect of the PICOS framework in clinical acupuncture research.